Gastro-intestinal devices designed for insertion into the digestive tract are commonly used in medical treatment. Such devices are used for removing gas and fluid from the gastro-intestinal tract, for performing diagnostic testing, and for the delivery of medications, fluids or nutrients into the gastro-intestinal tract. Typically, such gastro-intestinal devices are inserted by pushing the device through the oral cavity or the nasal passage into the esophagus of the patient. The devices generally include a flexible line or tube, designed to follow the contours of the digestive tract of the patient as it is inserted. However, the necessary flexibility of the line or tube also leads to difficulties during insertion of the device. As the flexible line or tube component is pushed into the pharynx of the patient, instead of remaining straight and passing into the esophagus it can coil in the back of the oropharynx. In addition, as the line or tube is inserted, following the contours of the pharyngeal surfaces, the inserted end of the gastric line tends to bend towards the trachea rather than the esophagus. Insertion procedures are further complicated by the fact that contact of the line or tube with structures of the oropharynx frequently induces a gag reflex in the patient. The speed and ease of the insertion procedure are critical to minimizing patient discomfort. Ideally gastric lines are quickly, yet carefully directed through the pharynx and into the esophagus while avoiding entry into the larynx. Gastric lines can also be inserted through the nostril. However, similar to the oral insertion protocol, successful placement of the gastric line through the nostril depends much on the skill of the physician--poor technique leads to extreme patient discomfort and tissue damage. For these and other reasons, current techniques for inserting tubes or lines of gastro-intestinal devices (hereinafter referred to generally as "gastric lines") require that the physician or technician possess a high level of skill.
One type of gastric line commonly inserted into the esophagus of patients is a gastro-intestinal tube for introducing or removing fluids. Gastro-intestinal tubes typically have a plurality of apertures located at or near the insert end of the tube. One additional disadvantage of current insertion methods is the tendency of the apertures to become clogged with mucus during the course of the insertion, or clogged with other matter present in the stomach.
Accordingly, there is a need for the development of new methods and devices which reduce the risk of inserting gastric lines into the trachea and which minimize patient discomfort caused by the insertion procedure.
One general object of this invention is to provide a method for inserting a flexible gastric line into the esophagus of a patient with minimal patient discomfort and with minimal risk of misdirection of the gastric line into the trachea.
Another object of this invention is to provide a gastric tube insertion kit which includes a guideline which can be easily located in a patient's digestive tract and used as a guide for gastric line insertion.
Still another object of the present invention is to provide a guide element which can be fixed in contact with a segment of a gastric line in a position at or near the inserted (gastric) end of the gastric line to decrease the flexibility of the contacted segment and to provide means for slideably engaging a pre-positioned transepiglottal guide line.
A further object of the invention is a mouthpiece for receiving and optionally guiding a gastric line through the oral cavity to minimize its contact with structures of the oropharynx, and retaining the gastric line in position in a patient's mouth, and protecting it from the biting surfaces of the teeth.